Low recto-vaginal fistula cured by Kshar Sutra (a medicated seton) treatment: a case report

Authors

  • Prasad Bapat Department of Ayurveda, Om Ayurvedic Clinic, Pune, Maharashtra, India
  • Vaidehi Bapat Department of Ayurveda, Om Ayurvedic Clinic, Pune, Maharashtra, India
  • Deepak Phalgune Department of Research, Poona Hospital and Research Centre, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253121

Keywords:

Ayurvedic treatment, Kshar Sutra, Recto-vaginal fistula, Seton

Abstract

Rectovaginal fistulas (RVFs) are challenging to treat, primarily due to their high recurrence rate and the risk of faecal incontinence following surgical intervention. A 30-year-old woman was suffering from low RVF.  An herbal medicated seton, known as 'Kshar Sutra,' was used to treat the patient. The local anaesthesia was used in and around the fistula track. Weekly thread changes were done on an outpatient basis for four weeks. There were no complications such as severe bleeding, secondary infection, severe pain, and incontinence. The patient has been fistula-free for the last 5 years. Low RVF can be treated safely by an herbal Kshar Sutra seton without any complications.

 

Metrics

Metrics Loading ...

References

Mocumbi S, Hanson C, Högberg U, Boene H, von Dadelszen P, Bergström A, et al. Obstetric fistulae in southern Mozambique: incidence, obstetric characteristics and treatment. Reprod Health. 2017;14(1):147. DOI: https://doi.org/10.1186/s12978-017-0408-0

Bahadursingh AM, Longo WE. Colovaginal fistulas. Etiology and management. J Reprod Med. 2003;48(7):489-95.

Sheedy SP, Bruining DH, Dozois EJ, Faubion WA, Fletcher JG. MR Imaging of Perianal Crohn Disease. Radiology. 2017;282(3):628-45. DOI: https://doi.org/10.1148/radiol.2016151491

Iwamuro M, Hasegawa K, Hanayama Y, Kataoka H, Tanaka T, Kondo Y, et al. Enterovaginal and colovesical fistulas as late complications of pelvic radiotherapy. J Gen Fam Med. 2018;19(5):166-9. DOI: https://doi.org/10.1002/jgf2.184

Tuma F, McKeown DG, Al-Wahab Z. Rectovaginal Fistula. 2023 May 14. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2025.

Beksac K, Tanacan A, Ozgul N, Beksac MS. Treatment of Rectovaginal Fistula Using Sphincteroplasty and Fistulectomy. Obstet Gynecol Int. 2018;2018:5298214. DOI: https://doi.org/10.1155/2018/5298214

Karp NE, Kobernik EK, Berger MB, Low CM, Fenner DE. Do the Surgical Outcomes of Rectovaginal Fistula Repairs Differ for Obstetric and Nonobstetric Fistulas? A Retrospective Cohort Study. Female Pelvic Med Reconstr Surg. 2019;25(1):36-40. DOI: https://doi.org/10.1097/SPV.0000000000000484

Ishimaru T, Kawashima H, Tainaka T, Suzuki K, Takami S, Kakihara T, et al. Laparoscopically Assisted Anorectoplasty for Intermediate-Type Imperforate Anus: Comparison of Surgical Outcomes with the Sacroperineal Approach. J Laparoendosc Adv Surg Tech A. 2020;30(3):350-4. DOI: https://doi.org/10.1089/lap.2018.0330

Rottoli M, Vallicelli C, Boschi L, Cipriani R, Poggioli G. Gracilis muscle transposition for the treatment of recurrent rectovaginal and pouch-vaginal fistula: is Crohn's disease a risk factor for failure? A prospective cohort study. Updates Surg. 2018;70(4):485-90. DOI: https://doi.org/10.1007/s13304-018-0558-9

Knuttinen MG, Yi J, Magtibay P, Miller CT, Alzubaidi S, Naidu S, et al. Colorectal-Vaginal Fistulas: Imaging and Novel Interventional Treatment Modalities. J Clin Med. 2018;7(4). DOI: https://doi.org/10.3390/jcm7040087

Bhome R, Monga A, Nugent KP. A transvaginal approach to rectovaginal fistulae for the colorectal surgeon: technical notes and case series. Tech Coloproctol. 2018;22(4):305-11. DOI: https://doi.org/10.1007/s10151-018-1775-4

Queralto M, Badiou W, Bonnaud G, Abramowitz L, Tanguy Le Gac Y, Monrozies X. Vaginal flap for rectovaginal fistulae in Crohn's disease. Gynecol Obstet Fertil. 2012;40(3):143-7. DOI: https://doi.org/10.1016/j.gyobfe.2011.08.010

Maeda K, Wada N, Shida A. Treatment of Rectovaginal Fistula. J Anus Rectum Colon. 2023;7(2):52-62. DOI: https://doi.org/10.23922/jarc.2023-007

Malik AI, Nelson RL. Surgical management of anal fistulae: a systematic review. Colorectal Dis. 2008;10(5):420-30. DOI: https://doi.org/10.1111/j.1463-1318.2008.01483.x

Singhal GD, Sharma KR. Bhagandara chikitsa adhyaya. In: Sushrutha Samhitha Ancient Indian Surgery Part II. Delhi: Chaukambha Sanskrit Samsthana. 1972;319-20.

Downloads

Published

2025-09-26

How to Cite

Bapat, P., Bapat, V., & Phalgune, D. (2025). Low recto-vaginal fistula cured by Kshar Sutra (a medicated seton) treatment: a case report . International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(10), 3601–3604. https://doi.org/10.18203/2320-1770.ijrcog20253121

Issue

Section

Case Reports